The Effectiveness of Guselkumab in Patients With Hidradenitis Suppurativa Under Clinical Practice Conditions: A Spanish Multicentre Retrospective Study

BACKGROUND

Hidradenitis suppurativa (HS) is a chronic skin condition causing lesions in which high levels of interleukin (IL)-23 and T-helper17 cells are found. Adalimumab remains the only approved treatment. Guselkumab, an antibody targeting the p19 protein subunit of extracellular IL-23, is approved for the treatment of moderate-severe psoriasis, but evidence on its efficacy in treating HS is limited.

OBJECTIVES

To assess the effectiveness and safety of guselkumab in treating moderate-severe HS under clinical practice conditions.

METHODS

A multicentre retrospective observational study was carried out in 13 Spanish hospitals including adult HS patients treated with guselkumab within a compassionate use programme (March 2020-March 2022). Data referred to patient demographic and clinical characteristics at treatment initiation (baseline), patient-reported outcomes (Numerical Pain Rating Scale [NPRS] and Dermatology Life Quality Index [DLQI]), physician scores (International Hidradenitis Suppurativa Severity Score System [IHS4], HS Physical Global Score [HS-PGA] and Hidradenitis Suppurativa Clinical Response [HiSCR]) were recorded at baseline and at 16, 24, and 48weeks of treatment.

RESULTS

A total of 69 patients were included. Most (84.10%) had severe HS (HurleyIII) and had been diagnosed for over ten years (58.80%). The patients had been subjected to multiple non-biological (mean: 3.56) or biological (mean: 1.78) therapies, and almost 90% of those treated with biologics had received adalimumab. A significant decrease in IHS4, HS-PGA, NPRS, and DLQI scores was observed from baseline to 48weeks of guselkumab treatment (all P<.01). HiSCR was achieved in 58.33% and 56.52% of the patients at 16 and 24weeks, respectively. Overall, 16 patients discontinued treatment, mostly due to inefficacy (n=7) or loss of efficacy (n=3). No serious adverse events were observed.

CONCLUSIONS

Our results indicate that guselkumab may be a safe and effective therapeutic alternative for patients with severe HS that fail to respond to other biologics.

The Effectiveness of Guselkumab in Patients With Hidradenitis Suppurativa Under Clinical Practice Conditions: A Spanish Multicentre Retrospective Study

BACKGROUND

Hidradenitis suppurativa (HS) is a chronic skin condition causing lesions in which high levels of interleukin (IL)-23 and T-helper 17 cells are found. Adalimumab remains the only approved treatment. Guselkumab, an antibody targeting the p19 protein subunit of extracellular IL-23, is approved for the treatment of moderate-severe psoriasis, but evidence on its efficacy in treating HS is limited.

OBJECTIVES

To assess the effectiveness and safety of guselkumab in treating moderate-severe HS under clinical practice conditions.

METHODS

A multicentre retrospective observational study was carried out in 13 Spanish Hospitals including adult HS patients treated with guselkumab within a compassionate use programme (March 2020-March 2022). Data referred to patient demographic and clinical characteristics at treatment initiation (baseline), patient-reported outcomes (Numerical Pain Rating Scale [NPRS] and Dermatology Life Quality Index [DLQI]), physician scores (International Hidradenitis Suppurativa Severity Score System [IHS4], HS Physical Global Score [HS-PGA] and Hidradenitis Suppurativa Clinical Response [HiSCR]) were recorded at baseline and at 16, 24, and 48 weeks of treatment.

RESULTS

A total of 69 patients were included. Most (84.10%) had severe HS (Hurley III) and had been diagnosed for over ten years (58.80%). The patients had been subjected to multiple non-biological (mean 3.56) or biological (mean 1.78) therapies, and almost 90% of those treated with biologics had received adalimumab. A significant decrease in IHS4, HS-PGA, NPRS, and DLQI scores was observed from baseline to 48 weeks of guselkumab treatment (all p<0.01). HiSCR was achieved in 58.33% and 56.52% of the patients at 16 and 24 weeks, respectively. Overall, 16 patients discontinued treatment, mostly due to inefficacy (n=7) or loss of efficacy (n=3). No serious adverse events were observed.

CONCLUSIONS

Our results indicate that guselkumab may be a safe and effective therapeutic alternative for patients with severe HS that fail to respond to other biologics.

Gallbladder Cancer Risk and Indigenous South American Mapuche Ancestry: Instrumental Variable Analysis Using Ancestry-Informative Markers

A strong association between the proportion of indigenous South American Mapuche ancestry and the risk of gallbladder cancer (GBC) has been reported in observational studies. Chileans show the highest incidence of GBC worldwide, and the Mapuche are the largest indigenous people in Chile. We set out to assess the confounding-free effect of the individual proportion of Mapuche ancestry on GBC risk and to investigate the mediating effects of gallstone disease and body mass index (BMI) on this association. Genetic markers of Mapuche ancestry were selected based on the informativeness for assignment measure, and then used as instrumental variables in two-sample Mendelian randomization analyses and complementary sensitivity analyses. Results suggested a putatively causal effect of Mapuche ancestry on GBC risk (inverse variance-weighted (IVW) risk increase of 0.8% per 1% increase in Mapuche ancestry proportion, 95% CI 0.4% to 1.2%, p = 6.7 × 10-5) and also on gallstone disease (3.6% IVW risk increase, 95% CI 3.1% to 4.0%), pointing to a mediating effect of gallstones on the association between Mapuche ancestry and GBC. In contrast, the proportion of Mapuche ancestry showed a negative effect on BMI (IVW estimate -0.006 kg/m2, 95% CI -0.009 to -0.003). The results presented here may have significant implications for GBC prevention and are important for future admixture mapping studies. Given that the association between the individual proportion of Mapuche ancestry and GBC risk previously noted in observational studies appears to be free of confounding, primary and secondary prevention strategies that consider genetic ancestry could be particularly efficient.

Development and internal validation of a multifactorial risk prediction model for gallbladder cancer in a high-incidence country

Since 2006, Chile has been implementing a gallbladder cancer (GBC) prevention program based on prophylactic cholecystectomy for gallstone patients aged 35 to 49 years. The effectiveness of this prevention program has not yet been comprehensively evaluated. We conducted a retrospective study of 473 Chilean GBC patients and 2137 population-based controls to develop and internally validate three GBC risk prediction models. The Baseline Model accounted for gallstones while adjusting for sex and birth year. Enhanced Model I also included the non-genetic risk factors: body mass index, educational level, Mapuche surnames, number of children and family history of GBC. Enhanced Model II further included Mapuche ancestry and the genotype for rs17209837. Multiple Cox regression was applied to assess the predictive performance, quantified by the area under the precision-recall curve (AUC-PRC) and the number of cholecystectomies needed (NCN) to prevent one case of GBC at age 70 years. The AUC-PRC for the Baseline Model (0.44%, 95%CI 0.42-0.46) increased by 0.22 (95%CI 0.15-0.29) when non-genetic factors were included, and by 0.25 (95%CI 0.20-0.30) when incorporating non-genetic and genetic factors. The overall NCN for Chileans with gallstones (115, 95%CI 104-131) decreased to 92 (95%CI 60-128) for Chileans with a higher risk than the median according to Enhanced Model I, and to 80 (95%CI 59-110) according to Enhanced Model II. In conclusion, age, sex and gallstones are strong risk factors for GBC, but consideration of other non-genetic factors and individual genotype data improves risk prediction and may optimize allocation of financial resources and surgical capacity.

The resilience of soil erosion rates under historical land use change in agroecosystems of Southern Spain

Land use change (LUC) is identified as one of the main drivers of soil erosion in the Mediterranean. However, very little information exists regarding the relationship between land use and erosion over longer time periods and on regional scales. We quantified the LUC in Southern Spain between 1956 and 2018, examining its effect on soil erosion and assessing the mitigation role of the permanent grassland (PG). The land use influence on erosion is represented by the RUSLE's C-factor, which was modelled using the Monte Carlo Method (MCM) based on historical LUC. Moreover, future LUC scenarios by 2038 were developed by binary logistic model (scFS) and by a complete conversion of PG to cropland (scPC), permanent crop (scPP) and forest and natural (scFP). Historically, Southern Spain has experienced an impressive intensification of its agricultural system. While soil loss variation is noted within the classes, no big variation is observed in cumulative erosion on a regional scale. The underlying reasons for this resilience are multifold, but mainly attributed to the fact that a small fraction of the total surface (20%), dominates total erosion (67%). The C-factor decrease in this area displays a LUC towards forest and natural area, suggesting an agriculture abandonment. On the other hand, the agricultural intensification that has taken place in the remainder of the area, contributes much less to overall soil erosion. Future LUC scenarios illustrate the importance of PG for erosion mitigation. scFS scenario does not project major changes. However, scCP and scPP, show an abrupt increase in regional erosion by 13% and 14%, while scFP shows a negligible reduction of erosion close to 0%. This allows to quantify the erosion mitigation offered by maintaining the PG and should be taken into account for future agricultural policy.

Identification of Circulating lncRNAs Associated with Gallbladder Cancer Risk by Tissue-Based Preselection, Cis-eQTL Validation, and Analysis of Association with Genotype-Based Expression

Long noncoding RNAs (lncRNAs) play key roles in cell processes and are good candidates for cancer risk prediction. Few studies have investigated the association between individual genotypes and lncRNA expression. Here we integrate three separate datasets with information on lncRNA expression only, both lncRNA expression and genotype, and genotype information only to identify circulating lncRNAs associated with the risk of gallbladder cancer (GBC) using robust linear and logistic regression techniques. In the first dataset, we preselect lncRNAs based on expression changes along the sequence "gallstones → dysplasia → GBC". In the second dataset, we validate associations between genetic variants and serum expression levels of the preselected lncRNAs (cis-lncRNA-eQTLs) and build lncRNA expression prediction models. In the third dataset, we predict serum lncRNA expression based on individual genotypes and assess the association between genotype-based expression and GBC risk. AC084082.3 and LINC00662 showed increasing expression levels (p-value = 0.009), while C22orf34 expression decreased in the sequence from gallstones to GBC (p-value = 0.04). We identified and validated two cis-LINC00662-eQTLs (r² = 0.26) and three cis-C22orf34-eQTLs (r² = 0.24). Only LINC00662 showed a genotyped-based serum expression associated with GBC risk (OR = 1.25 per log2 expression unit, 95% CI 1.04-1.52, p-value = 0.02). Our results suggest that preselection of lncRNAs based on tissue samples and exploitation of cis-lncRNA-eQTLs may facilitate the identification of circulating noncoding RNAs linked to cancer risk.

An analytical strategy for designer benzodiazepines and Z-hypnotics determination in plasma samples using ultra-high performance liquid chromatography/tandem mass spectrometry after microextraction by packed sorbent

The illicit market for new psychoactive substances (NPS) is continuously growing. Designer benzodiazepines (DBZD) and Z-hypnotics are increasingly being used for self-medication or recreational purposes. The limited regulation and little biological information available about NPS have raised the need for analytical methods capable of extracting and quantifying them in human biological fluids. In this work, a procedure based on microextraction by packed sorbent (MEPS) in combination with ultra-high performance liquid chromatography and tandem mass spectrometry (UHPLC-MS/MS) has been developed to determine the designer benzodiazepines (clonazolam, deschloroetizolam, nifoxipam, flubromazolam and meclonazepam), and the Z-hypnotics (zolpidem, zaleplon and zopiclone) in plasma. A 3³4²//16 asymmetric screening design was used to study extraction variables such as the type and volume of eluent, pH, number of extraction cycles, volume of washing solvent and type of sorbent. The ensuing analytical method was validated in terms of linearity by standard addition calibration curves at eight different analyte concentration levels from 0.5-500 ng mL^-1. R² values, limits of detection (LOD) and limits of quantification (LOQ) fell in the ranges 0.9900-0.9988, 0.5-5 ng mL^-1 and 1-10 ng mL^-1. Intra and interday precision expressed as relative standard deviations, were < 10.6 % and process efficiency ranged from 63 to 117 % for the quality control samples. The proposed method detected zolpidem and various other benzodiazepines in plasma samples from overdoses cases.

Lipid changes and tolerability in a cohort of adult HIV-infected patients who switched to rilpivirine/emtricitabine/tenofovir due to intolerance to previous combination ART: the PRO-STR study

Objectives

To analyse lipid changes and tolerability in a cohort of HIV-infected patients who switched their antiretroviral regimens to rilpivirine/emtricitabine/tenofovir (RPV/FTC/TDF) in a real-world setting.

Methods

PRO-STR is a 48 week prospective observational post-authorization study in 25 hospitals. Patients with a viral load <1000 copies/mL, receiving at least 12 months of combination ART (cART), with constant posology for at least the prior 3 months, were categorized according to previous treatment [NNRTI or ritonavir-boosted PI (PI/r)]. Analytical tests were performed at the baseline visit, between week 16 and week 32, and at week 48.

Results

A total of 303 patients were included (mean age 46.6 years; male 74.0%; previous treatment 74.7% NNRTI and 25.3% PI/r). Both groups exhibited significantly reduced lipid profiles, except for HDL cholesterol, for which a non-significant increase was observed. [NNRTI patients: total cholesterol (baseline: 195.5 ± 38.4 mg/dL; week 48: 171.0 ± 35.5 mg/dL), total cholesterol/HDL ratio (baseline: 4.2 ± 1.2; week 48: 4.0 ± 1.2), HDL (baseline: 49.1 ± 12.0 mg/dL; week 48: 49.2 ± 45.8 mg/dL), LDL (baseline: 119.2 ± 30.2 mg/dL; week 48: 114.2 ± 110.7 mg/dL), and triglycerides (baseline: 136.6 ± 86.8 mg/dL; week 48: 113.4 ± 67.8 mg/dL); PI/r patients: total cholesterol (baseline: 203.2 ± 48.8 mg/dL; week 48: 173.4 ± 36.9 mg/dL), total cholesterol/HDL ratio (baseline: 4.7 ± 1.6; week 48: 4.0 ± 1.2), HDL (baseline: 46.4 ± 12.5 mg/dL; week 48: 52.1 ± 54.4 mg/dL), LDL (baseline: 127.0 ± 36.3 mg/dL; week 48: 111.4 ± 35.8 mg/dL), and triglycerides (baseline: 167.6 ± 107.7 mg/dL; week 48: 122.7 ± 72.1 mg/dL)]. The most common intolerances were neuropsychiatric in the NNRTI patients and gastrointestinal and metabolic in the PI/r patients, and these intolerances were significantly reduced in both groups at week 48 [NNRTI: neuropsychiatric (baseline: 81.3%; week 48: 0.0%); PI/r: gastrointestinal (baseline: 48.7%; week 48: 0.0%) and metabolic (baseline: 42.1%; week 48: 0.0%)].

Conclusions

RPV/FTC/TDF improved the lipid profiles and reduced the intolerances after switching from NNRTI or PI-based regimens, in a cohort of HIV-infected patients.

Chemical risks associated with ready-to-eat vegetables: quantitative analysis to estimate formation and/or accumulation of disinfection byproducts during washing

Fresh produce can become contaminated with disease‐causing microorganisms and chemical contaminants at every step of the production and processing chain and in a variety of ways, including through contact with contaminated process water. Water quality is critical to prevent microbial and chemical risks in any of the postharvest and processing operations related to fresh and fresh‐cut fruits and vegetables. The wash process requires high volumes of water, which are usually reduced by water reuse. To maintain the microbiological quality of the process water, intervention strategies are needed. Chemical disinfection is the most common method to maintain the microbial quality of process water. However, the use of chemicals leads to the formation/accumulation of disinfection byproducts (DBPs), which can be absorbed by the washed vegetables. This is the case of trihalomethanes (THMs) and chlorates. The presence of high concentrations of DBPs in vegetables has led to an intensive debate on current disinfection practices and how DBPs may enter the food supply chain, becoming a potential health risk for consumers. To assess the risk associated with the formation/accumulation of DBPs in process water, a quantitative analysis was done. Available data have been used to develop mathematical models to predict the formation/accumulation of DBPs (chlorates and THMs) in process water due to the use of chlorine‐derived compounds. Preliminary models have been developed, but adjustments are still needed to refine them. The present study contributes more information related to the development of a mathematical model for the accumulation of chlorates and THMs in process water.

Factors associated with implementation of the 5A's smoking cessation model

Background

Several health organizations have adopted the 5A’s brief intervention model (Ask, Advise, Assess, Assist, Arrange), based on evidence-based guidelines for smoking cessation. We examine individual, cognitive, behavioral, and organizational factors associated with the 5A’s performance among clinical healthcare workers in Catalonia. We also investigate how these factors interact and potentially predict the implementation of each component of the 5A’s.

Methods

A cross-sectional survey was conducted among clinical health workers enrolled in an online smoking cessation training course (n = 580). The survey included questions about individual characteristics as well as cognitive, behavioral, and organizational factors previously identified in research. We assessed self-reported performance of the 5A’s, assessed on a scale from 0 to 10, and used Multivariate regression to examine factors associated with its performance.

Results

The performance means (standard deviation) were moderate for the first 3A’s [Ask: 6.4 (3.1); Advise: 7.1 (2.7); Assess: 6.3 (2.8)] and low for the last 2A’s [Assist: 4.4 (2.9); Arrange: 3.2 (3.3)]. We observed a high correlation between Assist and Arrange (r = 0.704, p < 0.001). Having positive experiences and feeling competent were positively associated with performing the 5A’s model and having organizational support with Assist and Arrange. Personal tobacco use among healthcare workers was negatively associated with Advice and Arrange.

Conclusions

Our study found that clinical healthcare workers do not perform the 5A’s completely. The main barriers identified suggest the need of training and making available practical guidelines in healthcare services. Organizational support is essential for moving towards the implementation of Assist and Arrange.

Electronic supplementary material

The online version of this article (10.1186/s12971-017-0146-7) contains supplementary material, which is available to authorized users.

The physiological consequences of ingesting a toxic plant (Diplotaxis tenuifolia) influence subsequent foraging decisions by sheep (Ovis aries)

Toxins and nutrients interact and define herbivores' experiences with toxic plants. However, there are still open questions about the mechanisms by which nutrient-toxin interactions affect experience and as a consequence foraging decisions by consumers. This study provides a deeper insight into such mechanisms by using supplemental nutrients, a toxic plant typically avoided by herbivores (wild rocket; Diplotaxis tenuifolia), and a small ruminant (sheep; Ovis aries) as models. Thirty-six sheep were randomly assigned to four treatments (n=9) where animals consumed: wild rocket ("DT"), wild rocket followed by a protein supplement ("DT+P"), wild rocket followed by a protein supplement+a mineral supplement containing iodine and copper ("DT+P+M"), or alfalfa pellets in amounts that paired the ingestion of wild rocket by DT ("CTRL"). Towards the end of the phase of exposure (day 35), DT showed the lowest intake of wild rocket, as well as reduced levels of plasma thyroid hormones (T3 and T4), alanine aminotransferase, and a trend towards reduced hemoglobin relative to DT+P and DT+P+M. Total concentration of serum proteins and albumins were greater in sheep fed the protein supplements, which have probably elicited a protective effect on toxin ingestion. Foraging behavior was then evaluated in an experimental arena where animals could select among randomly distributed buckets containing a fixed amount of wild rocket or variable amounts of barley grain (a preferred food). Regardless of barley grain availability, DT showed lower intake and lower times spent eating wild rocket than DT+P and DT+P+M. Unexpectedly, CTRL (without previous experience with wild rocket) ingested amounts of wild rocket comparable to those observed by DT+P and DT+P+M. A negative feeding experience with wild rocket is needed for animals to display the typical pattern of aversion commonly observed in grazing conditions.

Neuropeptide Y expression in primary cutaneous melanoma

BACKGROUND

Neuropeptide Y (NPY) is involved in the carcinogenesis of different tumours, especially neural crest-derived tumours.

OBJECTIVE

The aim of our study is to investigate the expression of NPY on melanoma and its relation with prognostic histological parameters and survival.

METHODS

This is a retrospective observational study of two independent series, with a total of 79 primary melanomas, diagnosed in two independent University Hospitals in Spain, from January 2000 to December 2004.

RESULTS

We found a significant higher expression of NPY on superficial spreading melanoma and lentigo maligna (40%) (P = 0.030). Thinner tumours were associated with higher NPY expression (Clark level, P = 0.003; Breslow level, P = 0.012). Melanomas with low NPY expression were associated with intense cell proliferation (Ki-67, P = 0.034), high density of peritumoral mast cell infiltrates (P = 0.033) and low E-cadherin expression (P = 0.031). Melanomas with high NPY expression exhibited significant differences in terms of relapse time (median: 114 vs. 68 months, P = 0.008) and overall survival (114 vs. 74 months, P = 0.004).

CONCLUSION

High expression of NPY was associated with better prognostic histological parameters, low peritumoral mast cells density, presence of adhesion proteins and better outcome.

How the foraging decisions of a small ruminant are influenced by past feeding experiences with low-quality food

Feeding experiences with low-quality foods can be improved when these foods are ingested in close temporal association with foods of higher nutritional quality. However, preference for low-quality foods in nature seems to be rather insensitive to past positive experiences and more related to their intrinsic nutritional value. An explanation for this observation is still lacking, mainly because little is known about how herbivores use information about low-quality foods during foraging. Our objective was to provide original information about this issue using a small ruminant (sheep; Ovis aries) as animal model. We manipulated the sheep's experience with a low-quality food (wheat straw) using a conditioning procedure ("oral-delay conditioning procedure"), and then we evaluated the use of this information in a simulated foraging scenario provided with wheat straw and a variable amount of a high-quality food in spatially separated feeding stations. Inclusion of wheat straw into the diet was strongly dependent on the availability of the high-quality food. We observed a threshold level in the availability of the high-quality food, which defined a zone of drastic change in the likelihood of inclusion of the wheat straw into the diet (i.e., acceptance or rejection of wheat straw). This threshold level did not change for sheep with (CS+) or without (CS-) a previous positive experience with wheat straw. However, once foraging conditions stimulated all sheep to start including the wheat straw into the diet (i.e., below the threshold level), the intake of this food was greater by CS+ sheep. This increased intake was not explained by a higher motivation to eat the wheat straw but to a greater amount of time spent foraging this food and less time spent searching for the preferred higher-quality alternative. We discuss these results based on optimal foraging models and learning models of diet selection.

Relationships between sources of acid mine drainage and the hydrochemistry of acid effluents during rainy season in the Iberian Pyrite Belt

In the Iberian Pyrite Belt (IPB), southwest Spain, a prolonged and intense mining activity of more than 4,500 years has resulted in almost a hundred mines scattered through the region. After years of inactivity, these mines are still causing high levels of hydrochemical degradation in the fluvial network. This situation represents a unique scenario in the world, taking into consideration its magnitude and intensity of the contamination processes. In order to obtain a benchmark regarding the degree of acid mine drainage (AMD) pollution in the aquatic environment, the relationship between the areas occupied by the sulfide mines and the characteristics of the respective effluents after rainfall was analysed. The methodology developed, which includes the design of a sampling network, analytical treatment and cluster analysis, is a useful tool for diagnosing the contamination level by AMD in an entire metallogenic province, at the scale of each mining group. The results presented the relationship between sulfate, total dissolved solids and electrical conductivity, as well as other parameters that are typically associated with AMD and the major elements that compose the polymetallic sulfides of IPB. This analysis also indicates the low level of proximity between the affectation area and the other variables.

Histological and histochemical study of the uropygial gland of chimango caracara (Milvago chimango vieillot, 1816)

The uropygial glands of birds are sebaceous organs that contribute to the water-repellent properties of the feather coat. We studied the histological and histochemical characteristics of the uropygial gland of chimango caracara using hematoxylin and eosin (H & E), Gomori´s trichrome, orcein, Gomori´s reticulin, periodic acid-Schiff (PAS), Alcian blue (AB) and a variety of lectins. The gland is composed of two lobes and a papilla with 20 downy feathers. It is surrounded by a capsule of dense connective tissue that contains elastic, reticular and smooth muscle fibers. The papilla is delicate and has two excretory ducts. The gland mass relative to body mass was 0.143%. Both adenomer cells and their secretions were stained with Sudan IV, PAS and AB, and were positive for numerous lectins that indicated the presence of lipids and carbohydrates. Immunohistochemical techniques to detect PCNA confirmed cell proliferation in the basal stratum of the adenomer cells. The lipids and glycoconjugates secreted by the uropygial gland serve numerous functions including protection against microorganisms.

Value of microarray allergen assay in the management of eosinophilic oesophagitis

BACKGROUND

Eosinophilic oesophagitis (EoE) is a disorder characterised by oesophageal dysfunction and, histologically, by eosinophilic inflammation. Although treatment, which includes dilatations, oral corticosteroids and restrictive diets, is often effective, choosing the foods to be eliminated from the diet is difficult.

OBJECTIVE

Component resolved diagnostic by microarray allergen assay may be useful in detecting allergens that might be involved in the inflammatory process.

METHODS

We studied 67 patients with EoE, diagnosed clinically and histologically by endoscopic biopsy. CRD analysis with microarray technology was carried out in the 67 EoE patients, 50 patients with pollen allergy without digestive symptoms, and 50 healthy controls.

RESULTS

Allergies were not detected by microarray in only seven of the 67 patients with EoE. Controls with pollen allergy showed sensitisation to different groups of pollen proteins without significant differences. In EoE patients with response to some allergens, the predominant allergens were grasses group 1 and, in particular, nCyn d 1 (Cynodon dactylon) or Bermuda grass pollen in 59.5%, followed by lipid transfer proteins (LTP) of peach (19.40%), hazelnut (17.91%) and Artemisia (19.40%).

CONCLUSIONS

In patients with EoE, sensitisation to plant foods and pollen is important. The proteins most frequently involved are nCyn d 1 and lipid transfer proteins, hazelnuts and walnuts. After one year of an array-guided exclusion diet and pollen-specific immunotherapy in the case of high levels of response, patients with EoE showed preliminary significant improvements.

Seasonal and spatial variation of organic tracers for biomass burning in PM1 aerosols from highly insolated urban areas

PM1 aerosol characterization on organic tracers for biomass burning (levoglucosan and its isomers and dehydroabietic acid) was conducted within the AERTRANS project. PM1 filters (N = 90) were sampled from 2010 to 2012 in busy streets in the urban centre of Madrid and Barcelona (Spain) at ground-level and at roof sites. In both urban areas, biomass burning was not expected to be an important local emission source, but regional emissions from wildfires, residential heating or biomass removal may influence the air quality in the cities. Although both areas are under influence of high solar radiation, Madrid is situated in the centre of the Iberian Peninsula, while Barcelona is located at the Mediterranean Coast and under influence of marine atmospheres. Two extraction methods were applied, i.e. Soxhlet and ASE, which showed equivalent results after GC-MS analyses. The ambient air concentrations of the organic tracers for biomass burning increased by an order of magnitude at both sites during winter compared to summer. An exception was observed during a PM event in summer 2012, when the atmosphere in Barcelona was directly affected by regional wildfire smoke and levels were four times higher as those observed in winter. Overall, there was little variation between the street and roof sites in both cities, suggesting that regional biomass burning sources influence the urban areas after atmospheric transport. Despite the different atmospheric characteristics in terms of air relative humidity, Madrid and Barcelona exhibit very similar composition and concentrations of biomass burning organic tracers. Nevertheless, levoglucosan and its isomers seem to be more suitable for source apportionment purposes than dehydroabietic acid. In both urban areas, biomass burning contributions to PM were generally low (2 %) in summer, except on the day when wildfire smoke arrive to the urban area. In the colder periods the contribution increase to around 30 %, indicating that regional biomass burning has a substantial influence on the urban air quality.

Changes in B and T-cell subsets and NMO-IgG levels after immunoglobulins and rituximab treatment for an acute attack of neuromyelitis optica

BACKGROUND

There is increasing evidence supporting that neuromyelitis optica (NMO) is an inflammatory humoral mediated disorder associated with NMO-IgG/AQP-4 antibodies. However, little is known about the subsets of B cells and T cells that contribute to the pathogenesis or therapy response.

OBJECTIVES

To describe the clinical and immunological changes associated with intravenous immunoglobulins (IV-Igs) plus rituximab (RTX) in a patient with a severe acute attack of NMO and intrathecal synthesis of NMO-IgG/AQP-4, who previously did not respond to intravenous methylprednisolone and plasma exchange.

METHODS

We sequentially analysed the levels of NMO-IgG/AQP-4 by immunohistochemistry, and B and T cells subsets by multiparametric flow-cytometry, in the CSF and peripheral blood (PB), before and alter IV-Igs plus RTX therapy.

RESULTS

In the CSF before treatment, and compared with PB, there was a higher percentage of CD4(+) T cells and a lower percentage of CD8(+) T cells and CD19(+) B cells. After therapy, the percentage of CD4(+) T cells remained high, and that of CD8(+) T cells increased. The observed decrease in the percentage of CD19(+) B cells was lower than in the PB. When the CSF was compared, it was found that the percentage of effector-memory and effector CD8(+) T cells had increased after therapy, and that of IgM memory B cells and switched-memory B cells decreased. The observed changes paralleled the decrease of NMO-IgG/AQP-4 results to negative and the clinical improvement.

CONCLUSIONS

Our findings confirm that, besides intrathecal humoral immune response against AQP4, B and T cell subsets are involved in the modulation of inflammation within and outside the central nervous system.

Measurement procedure to assess exposure to extremely low-frequency fields: a primary school case study

How to correctly measure the exposure of general public to extremely low-frequency (ELF) radiation is a key issue for ELF epidemiological studies. This paper proposes a measurement procedure to accurately assess the exposure of people to electric and magnetic field in the frequency band from 5 Hz to 100 kHz in buildings and their premises. As ELF radiation could be particularly harmful to children, the measurement procedure is focused on exposure to ELF in schools. Thus, the students' exposure to ELF fields can be assessed by correlating the ELF measurements to the hours of school activity. In this paper, the measurement protocol was applied to study the ELF exposure on students from García Quintana primary school in Valladolid, Spain. The campaign of measurements for ELF exposure assessment in this primary school was of great interest for the Regional Council of Public Health because of the social alarm generated by the presence of a significant number cancer cases in children.

Lactobacilli isolated from vaginal vault of dairy and meat cows during progesteronic stage of estrous cycle

Lactobacilli have been barely studied in cows. We proposed isolate and characterize lactic acid bacteria from dairy cows as compared to those raised for meat production and elucidate the presence of strains with evident probiotic employment's potential. For this, isolation and quantification of LAB mainly lactobacilli were realized from vaginal cattle samples in MRS medium. Each selected microorganism was then briefly characterized. The MATH method was employed using hexadecane, xilene an toluene as solvent. According to the hydrophobic characteristics, strains were classified into three categories: high (71-100%), medium (36-70%) and low (0-35%). Hydrogen peroxide qualitative production was studies too, lactobacilli were streaked onto an MRS agar plate containing 5 mg of 3,3',5,5'-tetramethylbenzidine and 0.20 mg of horseradish peroxidase. Twenty-one sampled cows (78%) were positive for lactic acid microflora, 12 belonging to the dairy group and 17 of the meat group. Total LAB counting including dairy and meat cows were log 2,41 CFU/ml. Of overall identified strains, an 83% corresponded to lactobacilli. Most strains belonged to the heterofermentative facultative group (75%), with L. plantarum as the most frequent specie. The highest proportion of isolated vaginal strains (69%) had low hydrophobicity, the LAB with highest hydrophobic characteristics (3 strains) were found only in meat cows. In the qualitative evaluation of H(2)O(2) production, a positive reaction was observed in 13 of 29 strains (45%). The role of lactobacilli in vaginal microbiota is limited, and therefore the present work is interesting in incorporate knowledge of normal microflora of progesteronic healthy cows, in this case in production animals. The isolation and characterization data obtained are consistent in consider the study of particular strains with great potential in the development of a probiotic for production cows.

Cytological characterization of sunflower by in situ hybridization using homologous rDNA sequences and a BAC clone containing highly represented repetitive retrotransposon-like sequences

In the present work we report new tools for the characterization of the complete chromosome complement of sunflower (Helianthus annuus L.), using a bacterial artificial chromosome (BAC) clone containing repetitive sequences with similarity to retrotransposons and a homologous rDNA sequence isolated from the sunflower genome as probes for FISH. The rDNA signal was found in 3 pairs of chromosomes, coinciding with the location of satellites. The BAC clone containing highly represented retroelements hybridized with all the chromosome complement in FISH, and used together with the rDNA probe allowed the discrimination of all chromosome pairs of sunflower. Their distinctive distribution pattern suggests that these probes could be useful for karyotype characterization and for chromosome identification. The karyotype could be subdivided into 3 clear-cut groups of 12 metacentric pairs, 1 submetacentric pair, and 4 subtelocentric pairs, thus resolving previously described karyotype controversies. The use of BAC clones containing single sequences of specific markers and (or) genes associated with important agricultural traits represents an important tool for future locus-specific identification and physical mapping.

Voids, nanochannels and formation of nanotubes with mobile Sn fillings in Sn doped ZnO nanorods

ZnO nanorods containing different hollow structures have been grown by a thermal evaporation-deposition method with a mixture of ZnS and SnO(2) powders as precursor. Transmission electron microscopy shows rods with rows of voids as well as rods with empty channels along the growth axis. The presence of Sn nanoprecipitates associated with the empty regions indicates, in addition, that these are generated by diffusion processes during growth, probably due to an inhomogeneous distribution of Sn. The mechanism of forming voids and precipitates appears to be based on diffusion processes similar to the Kirkendall effect, which can lead to void formation at interfaces of bulk materials or in core-shell nanostructures. In some cases the nanorods are ZnO tubes partially filled with Sn that has been found to melt and expand by heating the nanotubes under the microscope electron beam. Such metal-semiconductor nanostructures have potential applications as thermal nanosensors or as electrical nanocomponents.

[Use of nitrous oxide in Uruguay]

BACKGROUND

Nitrous oxide (N2O) is a medicinal gas that has been used for anesthesia for over a century and a half. As evidence of the adverse effects of N2O have been contrasted with the good safety profiles of new anesthetic agents, use of the older gas has declined.

OBJECTIVE

To describe and analyze the use of N2O for anesthesia in the Eastern Republic of Uruguay. To describe the use of other drugs for general anesthesia.

METHODS

The study had 2 phases. In the first phase, information on the use of N2O and other drugs for general anesthesia was obtained from the medical records of a sample of patients who underwent surgery between November 2007 and November 2008 at nationally important hospitals. In the second phase 80 physician anesthesiologists were surveyed to obtain information on their reported use of N2O for general anesthesia. The respondents were found working during the first half of 2008.

RESULTS

A total of 104 patients' records were read and 80 anesthesiologists were surveyed. We found that 31 (29.8%) patients received N2O during anesthesia. The survey showed that 62 (77.5%) of the anesthesiologists had used N2O in the last 6 months. Nine (50%) of the anesthesiologists who had not used N2O said their reason was that it was unavailable. The other 9 referred either to the risk of postoperative nausea and/or vomiting (n = 6) or the fact of having better alternatives (n = 9).

CONCLUSION

This study shows that N2O is little used in current anesthesia practice. The tendency in Uruguay continues to be toward declining use.

Growth and cathodoluminescence of Eu doped ZnO nanoneedles and branched nanoneedle structures

Rare-earth (RE) ions are widely investigated luminescent centers because their intraionic-4f transitions generate narrow and intense emission lines. In this work Eu doped ZnO nanoneedles have been grown, by a thermal evaporation-deposition method, and structural and luminescence characterization has been carried out. Mixtures of ZnO and Eu2O3 or of ZnS and Eu2O3 powders were used as precursors. Annealing of the compacted powder mixtures leads to the growth of nanoneedles and nanoneedle networks, as well as rods. EDS and CL measurements enable to detect the incorporation of Eu in these structures. The choice of precursor, ZnO-Eu2O3 or ZnS-Eu2O3 influences the morphology as well as the luminescence properties of the obtained nanostructures. In particular, while in the samples obtained from ZnO, the defect green luminescence band is practically absent, the band is present in the ZnO nanoneedles obtained from ZnS. Besides the broad deep level band, a series of well-separated narrow-peaks characteristic of the intrinsic red luminescence of Eu+3 ions are observed in all cases, whose relative intensities vary from one set of samples to the other. The results suggest that the Eu3+ ions have at least, two possible configurations in the ZnO lattice with different symmetry in the nanoneedles.